Epidemiologic changes of a longitudinal surveillance study spanning 51 years of scrub typhus in mainland China.

Scrub typhus may be one of the world's most prevalent, neglected and serious, but easily treatable, febrile diseases. It has become a significant potential threat to public health in China. In this study we used national disease surveillance data to analyze the incidence and spatial-temporal distribution of scrub typhus in mainland China during 1952-1989 and 2006-2018. Descriptive epidemiological methods and spatial-temporal epidemiological methods were used to investigate the epidemiological trends and identify high-risk regions of scrub typhus infection. Over the 51-year period, a total of 182,991 cases and 186 deaths were notified. The average annual incidence was 0.13 cases/100,000 population during 1952-1989. The incidence increased sharply from 0.09/100,000 population in 2006 to 1.93/100,000 population in 2018 and then exponentially increased after 2006. The incidence was significantly higher in females than males (χ2 = 426.32, P < 0.001). Farmers had a higher incidence of scrub typhus than non-farmers (χ2 = 684.58, P < 0.001). The majority of cases each year were reported between July and November with peak incidence occurring during October each year. The trend surface analysis showed that the incidence of scrub typhus increased gradually from north to south, and from east and west to the central area. The spatial autocorrelation analysis showed that a spatial positive correlation existed in the prevalence of scrub typhus on a national scale, which had the characteristic of aggregated distribution (I = 0.533, P < 0.05). LISA analysis showed hotspots (High-High) were primarily located in the southern and southwestern provinces of China with the geographical area expanding annually. These findings provide scientific evidence for the surveillance and control of scrub typhus which may contribute to targeted strategies and measures for the government.

Study on Sports, Extracurricular Activities, Electronic Device Usage Factors Associated with Chronic Fatigue Syndrome in Taiwanese Preschoolers.

Under the impact of the pandemic, electronic device usage has become the primary tool for learning. Due to social distancing restrictions, many sports facilities have been forced to close, resulting in changes in daily activities for preschool children. This research aimed to investigate the sports, extracurricular activities, and electronic device usage factors associated with chronic fatigue syndrome among Taiwanese preschoolers. Five-year-old preschoolers were randomly selected using a stratified multi-stage random cluster sampling method. The parents of the preschoolers completed the questionnaires, which contained items related to the symptoms of fatigue, extracurricular activities, and electronic device usage of their preschoolers. A total of 1536 valid questionnaires were returned. The data were then analyzed using descriptive statistics and the chi-square test. The following results were obtained: (1) the preschoolers who exercised at least three times per week, engaged in sweating exercise for at least 30 min at a time, had a continuous rhythmic exercise habit, and participated in a variety of exercise types experienced a lower degree of fatigue; (2) the preschoolers who engaged in extracurricular activities every day exhibited a higher degree of fatigue; (3) the preschoolers who watched television or used smartphones to pass the time due to boredom, watched television or used smartphones on holidays, played video games or surfed the Internet due to boredom, and played video games or surfed the Internet on holidays displayed a higher degree of fatigue. This research verified that regular exercise with various sports, extreme extracurricular activities, and laissez-faire electronic device usage are factors associated with fatigue syndrome in preschoolers. It is suggested to develop children's regular exercise habits, avoid excessive extracurricular activities, and guide their electronic device usage.

Sleeping and Dietary Factors Associated with Chronic Fatigue Syndrome in Taiwanese Preschoolers.

The purpose of this research was to investigate the sleeping and dietary factors associated with the prevalence of chronic fatigue syndrome among Taiwanese preschoolers. Five-year-old preschoolers were randomly selected using a stratified multistage random cluster sampling method. The parents of the preschoolers completed a questionnaire containing items related to symptoms of fatigue and sleeping and dietary habits among the preschoolers. A total of 1536 valid questionnaires were returned. After obtaining the data, the researchers analyzed them using descriptive statistics and a chi-square test. The following results were obtained: (1) chronic fatigue syndrome was typically indicated by yawning during the day, feeling tired, and appearing sleepy; (2) the preschoolers with high sleep quality, adequate sleeping time, and a regular sleep schedule exhibited a lower degree of fatigue; (3) half of the preschoolers who ate three nutritionally balanced meals a day at a regular time exhibited a lower degree of fatigue. Among the three dimensions studied, fatigue was most strongly associated with the "sleepy and inactive/blunted responses/lacking in energy" dimension, followed by the "difficulty concentrating" dimension, and, finally, the "localized pain" dimension. In this study, the association between sleeping habits and symptoms of fatigue in preschool children was verified. The associations of dietary factors with symptoms of fatigue were not confirmed. It is suggested that parents establish a good sleep schedule for preschool children based on the study findings.

Maternal Confidence and Parenting Stress of First-Time Mothers in Taiwan: The Impact of Sources and Types of Social Support.

The adjustment process to becoming a mother is affected by culture. However, earlier studies have not clarified the relationship between parenting stress, social support, and maternal confidence in non-Western women. This study examined the associations between different types and sources of social support, maternal confidence, and parenting stress experienced by first-time mothers. The sample consisted of first-time mothers with a child under one year of age in northern Taiwan, and a total of 205 valid questionnaires were collected. The results supported the stress-buffering hypothesis, which suggests that social support reduces the adverse effect of stress on maternal confidence. Although previous studies have suggested that spouses and maternal relatives are critical in supporting first-time mothers' transition into their new roles, each source did not show a mediator effect in our study. The beneficial effect of social support was found only when all social network members collectively participated. Regarding the types of social support, only appraisal support had a significant mediator effect; no effect was found for emotional, instrumental, or informational support. These findings add to our understanding of how different types and sources of social support play a role in helping first-time mothers adapt.